As a mid-career faculty physician in a family medicine residency program, I have taken a keen interest in the big picture of what is happening to the way our graduates and colleagues practice in the real world.  I’ve watched our residents as they prepare to graduate, deliberating among the most prevalent practice options presented to them in our region, usually as an employed doctor in a large multi-specialty practice, or ...

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I’ve noticed, as I get older life seems to travel full circle no matter your path or destination.  I find myself trying to teach my son Grant things that my father attempted to teach me not so long ago. “Don’t do that, you’ll fall and hurt yourself, or try it this way, and the process will be much easier.” There is that brief moment of acknowledgment often followed by scraped knees or ...

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Dear Macklemore, Recently, you -- the white-rapping, thrift-shopping, LGBT-activist-ing, Grammy-winning 2013 phenom -- teamed up with President Obama to deliver a message to the country about the current opioid epidemic. Now let me preface this by saying, I like you, Macklemore. I like the mixture of equal parts political, earnest and downright goofy that you bring to your music. I like that you seem genuinely self-reflective and ...

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"I love you," she said as I was leaving the room. Although I was stunned for a second or two, I wasn't really surprised.  She and I had gotten along famously from the beginning of our 15 minutes together.  She didn't "love me" in the way a patient with borderline personality disorder "loves" her enabling prescriber.  She loved me because I was there, I was experienced, I was kind, and I ...

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If that headline sounds like it can't possibly be true, that's because it isn't.  But British comedian John Oliver did recently give Americans a great lesson in bad "science," during a segment of his show, Last Week Tonight. Oliver often uses humor to take on serious social issues.  And what could be more serious than the news that smelling farts might prevent cancer? Lots of things, actually, as it turns out that ...

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Physicians are accustomed to seeing patients at the end of their lives.  It is difficult to let families know they may lose their loved one.  Clinicians are often accepting of patients DNR orders before family members are ready.  This story is about a time where the health care team was ill-prepared, yet a parent made the difficult decision to discontinue intervention.  It taught me an unforgettable lesson. During the first ICU ...

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What is your dream job? It’s the one you would do every day even if no one paid you. When you find it, you never really go to work each day, you go and play. If that is the kind of joy received from working, then burnout will likely be a long way out of reach. Are there any jobs like that out there for doctors? Yes, there are. But ...

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A good friend of mine recently found herself between jobs, with a gap in her health insurance and a recurrence of her kidney stones. What she needed were fluids and pain relief, fast. I'm a gastroenterologist, and hoping to minimize the financial impact, I went with her to our local ER and had a conversation with the attending physician. Maybe we could pass on the CT scan and extraneous lab ...

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Like many physicians, I’m a people pleaser.  On my medical school application, my personal statement was a literary cliché filled with my dreams of helping others, easing pain, soothing suffering -- and I really meant it.  What I didn’t know then was how difficult it would be to negotiate making patients happy while doing the right thing medically. Medical school and residency didn’t adequately prepare me for the emotional strain of ...

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My first confession is that I don’t really care to what extent a female emergency physician decides to embrace her femininity on the job. And yet, a new generation of female physicians is reshaping perceptions of our profession: what it takes to succeed, and therefore what sorts of skills, temperaments, and character types belong in our field. There is the nascent #ILookLikeaSurgeon campaign that started on Twitter and grew to its ...

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